Description, Causes and Risk Factors:

ICD-10: F81.0

Alternative Name: Mirror writing.

Strephosymbolia is defined as a form of dyslexia where text appears as if in a mirror, text is inverted backwards from right to left causing lower case fonts (q, b, d & p ) to appear as (qp db pq bd ) one appears the same as it's counterpart when placed in a mirror format. This is often confused as being dysgraphia.

This term was first introduced in 1925 by Dr Orton, an American neurologist of some signi?cance. He was probably the ?rst to recognize that children with reading dif?culties often reversed letters. This phenomenon he called strephosymbolia. He also introduced the term developmental alexia to describe these children with reading dif?culties. There were now three different terms in existence, all used to describe this learning difficulty. Mirror writers are often intrinsically left handed and mirror write with their left hands and may come from cultures, such as Chinese or Japanese, that normally write from right to left.

The reversals were a result of incompletely established lateral dominance, the dominant hemisphere of the brain, which usually controls language, stores one version of an “engram” such as was or b while the non-dominant hemisphere stores a mirror image of the engram — saw or d. If an individual has incompletely established dominance, then she or he will sometimes use the engram from the non-dominant hemisphere, and thus read or write the mirror image.

The disorder is caused by a neurological deficit. In other words there is something wrong inside the brain of the person. Up to 2.4% people with right hemiplegia exhibit transient strephosymbolia. Strephosymbolia are also associated different brain lesions, including left parietal lobe, left basal ganglia, and right supplementary motor area, suggesting that a single mechanism does not account for the phenomena.

Dyslexia is commonly considered a reading disorder that causes a person to read words or sentences backwards, or confuse letters such as "b" and "d." In fact, dyslexia is not limited to reading; rather it is a general language-related learning disorder, which can affect a person's ability to comprehend written communication, oral communication, or both. Strephosymbolia is the specific form of dyslexia that leads to a person seeing words or sentences backwards, or to confusing letters.


This disability is usually characterized by normal intelligence and normal learning capacity in other areas. Reversal of letters as individual symbols and in their sequence within the word is the most frequent source of error in both reading and writing, but it is not the only error encountered. This gives rise to an impression of a right-left disorientation in the patients which, however, has no counterpart in their orientation in general.


Strephosymbolia is difficult to diagnose. A psychologist or other health professional does a series of tests for diagnosis. The tests determine the child's reading and writing levels and compareit with its potential, which is evaluated by an intelligence test.


There is no known cure for strephosymbolia.

From the moment a disability is suspected, the parent and teachers need to work together and be careful to not allow the child to use a disability as a crutch for not working to the best of his or her ability.

Some people are able to write quite easily and naturally this way (for instance, the Italian inventor and artist Leonardo da Vinci famously kept his notebooks in mirror script). If a left-handed child has a tendency to mirror write, the teacher can help him or her overcome this by making sure the child always begins writing on the left side of the page. This can be done by placing a mark on the left side of child's paper showing which side to start writing from. If the mirror-writing persists, the teacher can try other strategies to help the child establish the correct direction and orientation of the letters. For instance, the child can be instructed to slowly and carefully copy text from a correctly written page. If the child has trouble even copying text, the teacher can have the child trace over correctly written words (in either case, remember to mark the starting point on the left side).

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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